PURPOSE: To examine the feasibility and outcomes of removing retrievable inferior vena cava (IVC) filters that have fractured. MATERIALS AND METHODS: Retrospective review of IVC filter retrievals over an 8-year period identified patients in whom there was an attempt to retrieve fractured filters and struts. Patient medical records were evaluated for filter type, recovery method for filter body and struts, removal attempt results, and complications. RESULTS: Between January 2002 and December 2010, 148 IVC filters were retrieved, 15 of which were fractured. All 15 fractured filter bodies were successfully retrieved. Nine of 15 fractured filters (60%) were removed in their entirety by using endobronchial forceps to retrieve the filter body and/or fractured struts. In three cases, forceps were used to retrieve the filter body and the fractured strut was removed with a snare. In six patients (40%), only the filter body could be removed, three with the Recovery Cone and three with endobronchial forceps. Failed attempts to remove fractured struts were made in three cases, with no attempt made in the remaining three. These struts were incorporated in the right ventricle, embedded in the IVC wall, or extraluminal. Minor caval defect was identified in five of 15 retrievals (33%); mild hemoptysis was noted in one case in which the strut was snared from a pulmonary artery. No major complications occurred. CONCLUSIONS: Fractured IVC filter bodies can be safely removed. Fractured filter struts can be removed when accessible, but are often in a position that makes retrieval not possible.
PURPOSE: To examine the feasibility and outcomes of removing retrievable inferior vena cava (IVC) filters that have fractured. MATERIALS AND METHODS: Retrospective review of IVC filter retrievals over an 8-year period identified patients in whom there was an attempt to retrieve fractured filters and struts. Patient medical records were evaluated for filter type, recovery method for filter body and struts, removal attempt results, and complications. RESULTS: Between January 2002 and December 2010, 148 IVC filters were retrieved, 15 of which were fractured. All 15 fractured filter bodies were successfully retrieved. Nine of 15 fractured filters (60%) were removed in their entirety by using endobronchial forceps to retrieve the filter body and/or fractured struts. In three cases, forceps were used to retrieve the filter body and the fractured strut was removed with a snare. In six patients (40%), only the filter body could be removed, three with the Recovery Cone and three with endobronchial forceps. Failed attempts to remove fractured struts were made in three cases, with no attempt made in the remaining three. These struts were incorporated in the right ventricle, embedded in the IVC wall, or extraluminal. Minor caval defect was identified in five of 15 retrievals (33%); mild hemoptysis was noted in one case in which the strut was snared from a pulmonary artery. No major complications occurred. CONCLUSIONS:Fractured IVC filter bodies can be safely removed. Fractured filter struts can be removed when accessible, but are often in a position that makes retrieval not possible.
Authors: Anthony K Guzman; Mahmoud Zahra; Scott O Trerotola; Leslie J Raffini; Maxim Itkin; Marc S Keller; Anne Marie Cahill Journal: Pediatr Radiol Date: 2016-01-21